Hope for cats with FIP

It came on suddenly.  Meow, normally vocal, the kind of cat that greets a full bowl of food head-on, was completely lethargic. Instead of eating, she vomited into her dish. Her ears felt hot—a good indication of fever.

At 8:30 a.m., Center Moriches Veterinary Hospital admitted her on arrival. By 9 a.m., Dr. Freedberg had some bad news. Meow was jaundiced. Her temperature was 104.6. Later, her lab reports showed a high white blood cell count, and with it a high risk for sepsis and organ failure. There was the possibility of hepatic lipidosis if she didn’t start to eat.

“On initial present, Meow appeared to be lethargic and febrile. She had some ocular changes,” said Dr. Freedberg.  “This presentation could mean a multitude of problems, including viral diseases like feline calicivirus, herpes virus or chlamydia infection.”
“Her blood work was showing a high globulin level. When we see a high protein level, fever and ocular changes, FIP is on my rule-out list.”

“Unfortunately, there is no specific blood test that will give you an absolute answer for FIP. In Meow’s case, we did an abdominal ultrasound to see what her intestines looked like. The test showed inflammation, which, with her symptoms, was highly suggestive of dry FIP.”

“FIP is known as feline infectious peritonitis. It is a viral disease that originates from feline coronaviruses (FCoV) and mutates into the form of FIP.  Feline coronavirus is a common virus usually seen in kittens and young cats. The virus can cause diarrhea, but in a small percentage of cats the virus will mutate into FIP.  Cats that are at higher risk are those under 2 years old, male cats, and cats in multiple cat households.

“There are two forms: the wet, or ‘effusive’ form, where the cat’s body fills up with fluid; the dry (or non-effusive) form, where the body has all over inflammation of the organs. This can cause the intestine to bunch together, ocular changes, and neurologic presentation.”

“FIP is a disease of exclusion and suspicion.  It is deadly if not treated.  Until recently, there was no treatment; cats would die within weeks of diagnosis. That is why it is so important to get a diagnosis and start treatment right away.”

“Once treatment is started, you get to see improvement within 48 to 72 hours.”

“BOVA GS—441524 is a nucleoside analogue which stops the virus from replicating by inserting itself into the virus’ forming RNA strand. It is 80 to 85 percent effective if the cat is treated daily for 12 weeks.  It comes in either a tablet or as an oral suspension.”

“The dosage is dependent on which form of the virus the cat has.  There are risks of a relapse in a small percentage of patients, mostly those with neurological symptoms. Side effects are mild and are manageable, including GI upset, elevated liver enzymes, elevated white blood cells.”

“There used to be no option for treatment. My patients that were diagnosed with FIP died. With this new medication, it’s no longer a death sentence.”

In New York State, BOVA GS—441524 is available by prescription. Following an examination and diagnosis, Dr. Freedberg called in Meow’s prescription to Stokes Pharmacy, a compounding pharmacy in New Jersey; it arrived the next afternoon. Initially resistant, she was easily medicated by mixing the liquid form into fishy tasting wet cat food

“The major disadvantage to this medication is the expense to treat and the continued follow-up care. My experiences with cases of FIP are mostly with rescue groups.  Unfortunately, sometimes the rescues don’t have the funds for treatment. Or they need time to raise the money and that can take a while.”

“Those that I have treated, though, have all had wonderful outcomes and are thriving,” she said.

And, after completing her treatment in August, Meow is one of them.

For more information about BOVA GS-441524 (available by patient prescription in all states and for office use in most cases through STOKES Pharmacy) and feline caretaker resources, i.e., clinical studies, on-demand webinars and more, visit stokespharmacy.com/fip.